- The Pacemakers

20 Nov 2023
Rishit Rao
Healthcare Industry
Last Edited 20 Nov 23

Antimicrobial resistance (AMR) stands as a formidable challenge to modern medicine, threatening to undermine the efficacy of antibiotics, antivirals, antifungals, and other essential medications. This emerging crisis poses a severe threat to global public health, requiring urgent attention and concerted efforts to mitigate its impact.

Understanding Antimicrobial Resistance:

Antimicrobial resistance occurs when microorganisms, including bacteria, viruses, fungi, and parasites, evolve and adapt to withstand the effects of medications designed to kill them. The misuse and overuse of antimicrobial drugs, both in healthcare and agriculture, accelerate this process, rendering once-treatable infections more challenging to manage.

Contributors to Antimicrobial Resistance:

1. Overprescription and Overuse: The inappropriate prescription of antimicrobials for viral infections, where they are ineffective, contributes significantly to resistance. Additionally, the overuse of these drugs in healthcare and agriculture further exacerbates the problem.

2. Incomplete Treatment Courses: Failure to complete prescribed courses of antimicrobial medications allows surviving microbes to develop resistance. It is crucial for individuals to follow healthcare professionals' recommendations and complete full treatment courses.

3. Use in Agriculture: The widespread use of antimicrobials in agriculture for promoting growth and preventing disease in animals contributes to the presence of these drugs in the environment. This exposure can lead to the development of resistant strains that affect both animals and humans.

Global Impact:

AMR is not confined by borders; it's a global challenge with far-reaching consequences. Common infections could become deadly, routine medical procedures more dangerous, and the economic burden on healthcare systems and societies at large could be staggering.

The Role of Education and Awareness:

Raising public awareness about the responsible use of antimicrobials is paramount. Educating healthcare professionals, policymakers, and the general public about the consequences of AMR is essential for fostering a collective understanding of the issue and driving behavioral change.

Preventive Measures:

1. Strengthening Regulations: Governments and international bodies must enforce and enhance regulations on the use of antimicrobials in healthcare and agriculture. This includes monitoring and controlling prescription practices and limiting the use of these drugs in food production.

2. Research and Development: Investing in research for new antimicrobial drugs is critical. The development of novel antibiotics and alternative treatments can provide essential tools in the fight against resistant infections.

3. International Collaboration: AMR requires a united global response. International collaboration, data sharing, and coordinated efforts are essential to combat this crisis effectively.

Role of Doctors and Healthcare Professionals-

Antimicrobial Stewardship

In an era of increasing prevalence of multidrug -resistance bacteria and with a substantial amount of inappropriate antimicrobial use,the need for rationale antimicrobial prescribing has never been greater

Antimicrobial stewardship describes the practice of promoting the selection of the appropriate drug, doses,route,and duration of antimicrobial therapy. Antimicrobial stewardship programs implement a variety of strategies to-

01.Improve patient care through appropriate antimicrobial use,

02.Decrease the development of resistance within patients and population

03.Reduce the incidence of adverse effects and

04.Control costs..

Infections caused by resistant pathogens result in significant morbidity and mortality as well as increased healthcare costs.Antimicrobial stewardship programs are typically multidisciplinary and often include infection disease physicians,clinical pharmacists,clinical microbiologist,information system specialists ,infection prevention and control practitioners and epidemiologists.

These teams employ a variety of approaches to achieving the program's goals .

Established strategies of antimicrobial stewardship programs include

01.Prospective audit of antimicrobial use,with intervention and feedback

02.Formulary restrictions and

03.Preauthorisation

Additional strategies used in specific healthcare settings are

01.Guidelines and pathways

02.Dose optimization

03.Parenteral- to -oral conversion

04. Antibiotic time-out

05. De-escalation of therapy

06.Documentation of indication for which each antimicrobial is prescribed

Antimicrobial stewardship is an evolving area and an increasingly active area of research aimed at identifying the best practices.The IDSA,in collaboration with several other professional organisations has published guidelines for developing institutional antimicrobial Stewardship programs.

(www.idsociety.org/Antimicrobial _Agents/)

Conclusion:

Antimicrobial resistance is a complex and urgent challenge that demands our immediate attention. By understanding the factors contributing to resistance, promoting responsible use, and fostering international collaboration, we can work together to preserve the effectiveness of these vital medications and ensure a healthier future for generations to come.

Antimicrobial Resistance: The Looming Crisis and Our Collective Responsibility

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